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Published on: February 29, 2020
Abnormal tympanography after supine bottle feeding
S B Tully1, Y Bar-Haim, R L Bradley
1Department of Pediatrics, University of California, Los Angeles, School of Medicine 91342-1495, USA.
Insights
Feeding infants in a supine position may lead to milk entering the middle ear, potentially causing ear infections. A semiupright position is recommended to prevent this, with repositioning after feeding possibly helping normalize ear pressure.
Area of Science:
- Pediatrics
- Otolaryngology
- Public Health
Background:
- Otitis media is a common childhood illness.
- Bottle feeding practices may influence middle ear health.
- The supine feeding position is a potential risk factor.
Purpose of the Study:
- To investigate the association between supine bottle feeding and middle ear pressure changes.
- To determine if milk aspiration into the middle ear occurs during supine feeding.
- To assess the impact of feeding position on infant ear health.
Main Methods:
- A study involving 90 infants aged 7-24 months.
- Infants were bottle-fed in either supine or semiupright positions.
- Tympanometry was used to assess middle ear pressure before and after feeding.
Main Results:
- 59.6% of infants fed supine showed abnormal tympanograms post-feeding.
- Only 15% of infants fed semiupright had abnormal results (p < 0.005).
- Repositioning infants after feeding often normalized tympanograms.
Conclusions:
- Supine bottle feeding significantly affects middle ear pressure, likely due to milk aspiration.
- Feeding infants in a semiupright position is advisable.
- Repositioning infants post-feeding may mitigate negative effects on middle ear pressure.
Objective:
To determine whether bottle feeding with the infant in the supine position is related to entry of milk into the middle ear, thereby predisposing the infant to otitis media.
Study Design:
Ninety children, aged 7 to 24 months, who were free of respiratory infection and had normal tympanograms initially, were bottle fed in either the supine or the semiupright position, and tympanography was repeated immediately afterward.
Results:
Thirty-four (59.6%) of the 57 infants fed in the supine position had abnormal postfeeding tympanographic results compared with only five (15%) of the 33 infants fed in the semiupright position (p < 0.005). In addition, when the infants with abnormal tympanograms were placed in semiupright or prone positions for 15 minutes after feeding, the majority of tympanograms returned to normal.
Conclusion:
These data suggest that supine bottle feeding has a significant effect on middle-ear pressure dynamics, probably caused by the aspiration of milk into the ear. The results also suggest that repositioning infants after feeding may mitigate the effects of supine feeding, at least in healthy children. Although this study did not demonstrate that tympanographic abnormality definitely predisposes to otitis media, it provides more evidence to encourage the practice of feeding infants in a semiupright position.
